Current through Reg. 50, No. 187; September 24, 2024
(1) Each behavioral
qualified residential treatment program (BQRTP) providing services for youth
who have serious emotional or behavioral disorders or disturbances must meet
the licensing requirements set forth in rules
65C-46.001 through
65C-46.014, F.A.C., in addition
to the program standards in this rule.
(2) File Requirements. Each BQRTP shall
obtain a copy of all of the child's assessments completed as outlined in
65C-28.021, F.A.C., and place it
in the child's file. Each BQRTP serving non-dependency youth shall obtain a
copy of an independent assessment confirming the child meets criteria to
receive services in a BQRTP.
(3)
Each BQRTP shall work in conjunction with the qualified individual, as defined
in Rule 65C-28.021, F.A.C., conducting
all assessments.
(4) Training.
(a) Each BQRTP shall ensure all direct care
staff complete pre-service training requirements in Rule
65C-46.011(9)(c),
F.A.C., and receive an additional 24 hours of specialized training specific to
the treatment of serious emotional or behavioral disorders or disturbances.
Topics shall include the following:
1.
Emotional disturbances in children and common behavioral problems
exhibited;
2. Behavior management,
theory, and skills;
3. Discipline,
limit-setting, logical consequences, problem-solving, and relationship building
skills;
4. Crisis intervention and
emergency procedures;
5. Behaviors
and emotional issues of children who have been sexually abused, are sexually
reactive, or have developmental disabilities;
6. Working with biological or adoptive
families;
7. Motivational
Interviewing; and
8. Understanding
the impact of trauma.
(b)
Of the 40 hours of annual in-service training required in rule
65C-46.011(9)(d),
F.A.C., eight (8) hours shall focus on the treatment of serious emotional or
behavioral disorders or disturbances.
(5) Staffing.
(a) Each BQRTP shall have staff experienced
in addressing maladaptive behaviors, registered or licensed nursing staff, and
other licensed clinical staff who are:
1.
On-site as outlined in the BQRTP's trauma-informed treatment model;
2. Available 24-hours a day, seven (7) days a
week for response; and
3. May be
contracted providers.
(b)
Each BQRTP may utilize a shift care staffing model or house parent
model.
(6) Accreditation.
Each BQRTP must be accredited by one of the following organizations:
(a) Commission on Accreditation of
Rehabilitation Facilities (CARF);
(b) The Joint Commission;
(c) Council on Accreditation (COA);
or
(d) Any other not-for-profit
accrediting agency approved by the Department.
(7) Admission.
(a) Each BQRTP shall develop an admission
plan that outlines the intake procedures and identifies exclusionary
criteria.
(b) Children requiring
services and treatment for acute emotional or behavioral disorders or
disturbances outlined in s.
394.492(5) and
(6), F.S., should be referred to a
residential treatment center licensed under 65E-9, F.A.C.
(8) Basic Service Requirements.
(a) Each BQRTP shall develop a policy
outlining the program's trauma-informed treatment model that addresses the
clinical needs of children with emotional or behavioral disorders or
disturbances and is able to implement the treatment identified for the child.
The policy shall address the staffing requirements needed to implement the
trauma-informed model.
(b) Each
BQRTP must provide time-limited, high-quality, supportive services for youth
including:
1. Substance abuse and mental
health screening and treatment, if applicable;
2. Family/group/individual therapy;
3. Behavioral management;
4. Psychiatric services;
5. Support groups;
6. Specialized intervention
services;
7. Social &
rehabilitative services; and
8.
Psycho-educational services.
(c) Each BQRTP shall develop a policy
outlining the requirement to facilitate participation of family members in the
child's treatment program including:
1.
Inclusion in family therapy;
2.
Outreach to family members, including siblings;
3. Documenting how family members are
integrated into the treatment process for the child, including post-discharge;
and
4. Documenting how sibling
connections are maintained.
(d) Each BQRTP shall ensure that emotional
safety and recovery are assessed, and precautions are taken in regard to the
safety of other children in the same setting.
(9) Each BQRTP is responsible for the
development of treatment plans as outlined in Rule
65C-46.012(13),
F.A.C. Any BQRTP enrolled as a Medicaid provider, must complete treatment plans
in accordance with Medicaid policy requirements.
(10) Discharge and Aftercare Plans.
(a) The provider shall have, and use on an
ongoing basis, a written procedure on discharge planning and aftercare supports
that specifies the availability of services and the persons responsible for
implementation of the aftercare supports.
(b) Each BQRTP shall provide discharge
planning and family-based aftercare support for at least six (6) months
post-discharge.
(c) Discharge
planning shall include input from the child, the child's parent or guardian,
foster parents, caregiver, Department, and guardian ad litem, and a copy shall
be provided to the child welfare professional.
(d) The child's diagnosis(es) shall be
considered during discharge planning and development.
(e) Aftercare support plans shall be
developed at least one month prior to discharge.
(f) Aftercare support shall be developed to
meet the needs of a child with intent for the child to reside in the most
appropriate, least restrictive setting.
(g) Aftercare Support Eligibility for
Dependency Youth. Aftercare support must be offered to all children placed in a
BQRTP setting. Aftercare support is not required for youth who discharge to
another BQRTP setting or higher level of care to include residential treatment
programs, also known as Statewide Inpatient Psychiatric Program (SIPP), or a
therapeutic group home which are defined in s.
39.407(6),
F.S.
(h) Aftercare Supports. Each
BQRTP shall provide the following aftercare supports:
1. Community service coordination for the
youth and their family/caregiver;
2. Ensure all service referrals are linked
and barriers to access services are eliminated;
3. Provide a minimum of two (2) contacts per
month, with at least one face to face contact, with the youth and
family/caregiver;
4. Provide
written progress reports every 30 calendar days to the youth's child welfare
professional, if in foster care.
(i) When a youth is discharged to a placement
setting outside a 50-mile radius of the provider, the BQRTP must coordinate
aftercare support with the community-based care lead agency having jurisdiction
of the youth. The community-based care lead agency shall resume responsibility
for the aftercare support services provided to the dependency youth.
(j) Each BQRTP may contract/sub-contract with
a community provider qualified to provide aftercare
services.
Rulemaking Authority
409.175(5) FS.
Law Implemented 409.175
FS.
New 1-28-24.